Welcome Back
We hope that you, like Congress, enjoyed some time off last week and are ready to dive in—for a few days at least. As we previously reminded you, the House is only in session 12 days in July, then away for August recess, and in session for another 12 days in September. That means there are only 24 voting days in the House (and 32 in the Senate) before the end of the fiscal year, September 30.
There is much to do in this timeframe, and only a portion of that work relates directly to healthcare. The Pandemic and All-Hazards Preparedness Act (PAHPA) is set to expire at the end of the fiscal year. Overall, there is much agreement on the value of the law, and consensus is building around reauthorization. Over the next few weeks, PAHPA language will be fine-tuned, and Members of Congress are likely also trying to attach additional provisions on items of importance. What can be attached to PAHPA remains to be seen, but it will be an important healthcare vehicle over the next few months.
Administration
The Biden Administration is in the midst of releasing much-awaited proposed rules and requests for information.
On July 7, the Consumer Financial Protection Bureau, the US Department of Health and Human Services, and the US Department of the Treasury issued a request for information (RFI) related to medical credit cards, loans and other financial products used to pay for healthcare. In addition to questions in the RFI around the potential for consumer harm, potential distortion of provider incentives and more, HHS included its own set of questions related to how medical payment products have intersected with federal health programs (like Medicare and Medicaid), federal laws against healthcare fraud and abuse, and Affordable Care Act and No Surprises Act protections. This RFI has a 60-day comment period.
Also on July 7, the Centers for Medicare and Medicaid Services (CMS), along with the Departments of Treasury and Labor, released a notice of proposed rulemaking on short-term limited-duration insurance (STLDI) and fixed indemnity insurance. As described in the fact sheet, the proposed rule would change the definition of STLDI by limiting the terms of these plans to three months, permitting only one additional month of renewal, banning “stacking” of multiple terms within a 12-month period and improving consumer disclosures. The proposed rule also requested comments on specified disease excepted benefits coverage and level-funded plan arrangements. Comments are due by September 11.
CMS also released the Hospital Outpatient Prospective Payment System: Remedy for 340B-Acquired Drugs Purchased in Cost Years 2018-2022 proposed rule on July 7 to address how the agency will restore payments to hospitals affected by a 2018 decision to cut reimbursement amounts on 340B drugs to certain hospitals paid under the Outpatient Prospective Payment System. This proposed rule is responsive to a Supreme Court of the United States opinion finding that the 2018 payment cuts were inconsistent with CMS authority to set Medicare payments to hospitals for outpatient drugs. The rule would provide a $9 billion remedy for hospitals that received a cut in 340B payment from 2018 through 2022. Hospitals would receive the remedy in a lump sum payment. Comments are due September 5.
We also anticipate that the 2024 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System proposed rules will be released early this week. As always, we will publish summaries of these proposed rules, and we are always available to help analyze how the proposals may affect you and your work.
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